Treatment of Depression
Everyone, from time to time , we feel a bit ' sad or down in the dumps , but these feelings are usually temporary and disappear after a few days

Wednesday, October 2, 2013

Depression

Treatment of Depression

Everyone, from
time to time , we feel a bit ' sad or down in the dumps , but these feelings
are usually temporary and disappear after a few days . Depressive
disorder , however , interferes with daily life and the performance of normal
duties , in addition to causing pain to both the person affected and those who
live in close contact with her. Depression
is a common disease, but that should not be underestimated and the majority of
people who suffer from it must resort to therapy to feel better .

Many
patients do not cure but most of them, including those suffering from more
severe forms of depression may find relief with treatment . Extensive
research led to the development of drugs , psychological therapies and other
methods to treat people suffering from this debilitating disease.

Forms of depression

There are
different types of depressive disorder . The
most common forms are major depressive disorder and dysthymic disorder .

Major
depressive disorder , also called major depression, is characterized by a
combination of symptoms that interfere with their ability to work , sleep ,
study, eat, and feel pleasure in activities that first captivated the patient. Major
depression is disabling and prevents the person from fulfilling its functions
normally . The
episode can be unique and occur only once in the life of the patient, or, in
most cases , may be used for the whole life .

The
dysthymic disorder , also called dysthymia , is characterized by symptoms in
the long term (two years or more), but less severe : the symptoms are not
disabling but may prevent the patient to carry out its functions normally or
feeling well. Distimiche
people can also suffer from one or more major depressive episodes over a
lifetime .

Some
forms of depressive disorder have slightly different characteristics from those
described above , or you can develop only in certain circumstances . However,
the researchers do not all agree on the definition and characterization of
these forms of depression. Among
them are:

Psychotic
depression occurs when a severe depressive disorder is accompanied by some form
of psychosis , such as detachment from reality , hallucinations and delusions .

Postpartum
depression is diagnosed when the new mother has a severe episode of depression
within the month following childbirth . It
is estimated that a variable percentage of 10 to 15 percent of women suffer
from postpartum depression after giving birth to a son .

Seasonal
Affective Disorder is characterized by the occurrence of major depressive
disorder during the winter months , when there is less sunlight. This
form of depression usually fades during the spring and summer months . SAD
may be effectively treated with light therapy , but nearly half of patients
with this disorder do not improve if the therapy is the only treatment adopted.
Antidepressants
and psychotherapy may lessen the symptoms of the DAS , or alone or in
combination with phototherapy .

Bipolar disorder , also called manic depression , is less common than major
depression and dysthymia . Bipolar
disorder is characterized by cyclical mood swings , from a very elated mood
(mania ) in a very black mood ( depression).

Causes

The
specific causes of depression are still unknown, as in the case of many other
mental diseases it is believed that depression is caused by a set of
biochemical factors , genetic and environmental .

Biochemical
factors . Some
evidence obtained with advanced imaging techniques show that depressed people
have brain changes . The
importance of these changes is still uncertain but may eventually help to
identify the causes of the disease. Even
the neurotransmitters , the chemicals that are found in the brain and are
linked to mood , might play a role in depression as , one supposes, the
hormonal imbalances.

Genetic
factors.Some
research shows that depression is more common among people with family
depressed. Researchers
are trying to identify the genes that may be responsible for depression.

Environmental
factors.The environment may
play a causal role . Environmental
causes are all situations of life difficult to deal with , such as the
disappearance of a loved one , economic problems and high stress .

Risk Factors

Although
there are no accurate statistics, depression is considered to be relatively
common . Each
year in the United States, about 12 million people become ill with depression,
which transcends all barriers of race , ethnicity and economic status : no one
is immune from the risk of getting sick.

It
occurs normally at about thirty years , but can start at any age , affecting
virtually anyone from children to seniors . In
women is diagnosed twice as likely than men, but this may be partly due to the
fact that women do care more easily.

Although
the exact cause is still unknown , researchers have identified several factors
that appear to increase the risk of development or onset of the disease , among
them are:

Fighting
against depression can be very difficult , because it is a disease that makes
it more difficult to adopt behaviors and engage in activities that may help you
to feel better . Ask
your doctor or specialist how can we improve the styles of fighting disease ,
and keep these tips in mind :

Not
complicate in life .Reduce
the commitments required , if possible, and give yourself a reasonable
timeframe to achieve your goals .

Keep a diary,
in which you express pain, anger , fear or other emotions .

Read books
that offer a reliable method of self -help and talk to your doctor or healthcare
professional.

Not Isolate . Try
to participate in normal activities and to find regularly with family or
friends.

Attend a
support group for depressed people : in this way you make contact with other people who are facing problems
similar to yours.

Recovery from
depression is a gradual process.Stay
motivated , bearing in mind the objectives of healing. Remember
that the management of the disease and the achievement of your goals are your
responsibility .

Among
mental illnesses , depression plays a prince, we are talking about a complex
disorder that refers , essentially , a significant mood disturbance . In other
words, depression can be described as a feeling of sadness, unhappiness and
frustration, often associated with anxiety , stress and suicidal thoughts .

Depression : Causes

Depression
can be the result of more or less serious diseases (eg, alcoholism, renal
impairment , hypothyroidism and hyperparathyroidism, Hashimoto's disease ,
Alzheimer's disease and Parkinson's disease, premenstrual syndrome , tumors),
but it is often a result of psychological distress / emotional originated from
disappointments work / emotional , social isolation , stress , neglect of self.

Depression : Symptoms

There
are many types of depression, sometimes distinguished on the basis of severity
and intensity of the symptoms that characterize them : agitation , anxiety ,
apathy, appearance of unexplained physical problems ( back pain and headaches)
, difficulty concentrating , insomnia / hypersomnia , lack of sexual desire,
thoughts of death , loss of interest, tearfulness , sadness .

Depression : Diet and nutrition

Information
on Drugs for the treatment of depression are not intended to replace the direct
relationship between health professional and patient. Always consult your
doctor and / or healthcare professional before taking drugs for the treatment
of depression .

Depression drugs

For
the treatment of depression are available numerous cures ; generally , to
achieve a cure in a shorter time , the patient is subjected to cross-
treatments , namely either based on the approach psychotherapeutic ,
pharmacological and on that . Clearly, to ward off the disease , the patient
who is affected must have willpower and work , trying to look at what surrounds
it according to a different, better : in doing so, the patient can achieve positive
results in shorter time .

As
mentioned, the depression constitutes a pathological condition heterogeneous
and multifactorial , therefore the choice of a drug instead of another , and a
specialist rather than another , essentially depends on the severity of the
condition . Some patients complain of a slight depression so you do not need
drugs to even complete healing , while others , fall into a depression so deep
that I could not re-emerge, nor with psychiatrists or with antipsychotics.

The
following are classes of drugs most used in therapy against depression , and
some examples of pharmacological specialties ; up to the physician to choose
the active substance and the dosage most suitable for the patient , based on
the severity of the disease , the state of health the patient and his response
to treatment :

Tricyclic antidepressants : useful for the treatment of depression of medium
and severe , possibly associated with physical ailments . These medications are
not indicated to treat mild depression acute grade . Still, the tricyclics are
widely used in therapy for depression associated with alteration in appetite ,
insomnia, hypersomnia , and related disorders. Most often , the first symptom
of rehabilitation is to improve the quality of sleep , clearly altered by
depression.

Amitriptyline ( Elavil eg , Triptizol ,
Adepril ): Initially , the drug can be taken at a dose of 75 mg daily , in
divided doses over 24 hours , the dose may be increased up to 150-200 mg . For
teenagers and older people with depression, the initial dose is 30-75 mg . The
drug should be taken preferably at bedtime.

Imipramine (eg Imipra C FN , Tofranil ):
Initially , the drug should be taken at a dose of 75 mg per day in divided
doses . You can increase the doses up to 150-200 mg, in some depressed patients
hospitalized , the dose of the drug may increase to 300 mg per day. The maximum
dose to be taken before bed is usually 150 mg . This dosage should be reduced
when administered to elderly patients .

Nortriptyline (eg Dominans , Noritren )
: at the beginning of antidepressant therapy , it is recommended to take a
low dose of medication and gradually increase up to 75-100 mg per day , to be
split in multiple doses during 24 hours. For teenagers and elderly people with
depression, it is recommended that a lower dose (30-50 mg daily) .

These
described above are just a few of the many tricyclic drugs , among others,
include: clomipramine, dosulepina , doxepin , trazodonelo , fepramina .Currently
, the tricyclics are not used in therapy because of their obvious side effects:
changes in vision, anorgasmia , weight gain , hypertension, sexual difficulties
, fluid retention, tachycardia .

Selective serotonin reuptake inhibitors : These drugs , second-generation
antidepressants , tricyclic replaced in a short time due to its lower side
effects : These drugs , in fact, are deprived of the cholinergic , instead
implicated in the manifestation of the side effects of tricyclic
antidepressants . The selective serotonin reuptake inhibitors are not effective
for severe forms of depression.

Fluoxetine (eg, Prozac , Azur , Flotina , Fluoxeren ) : Depending on the severity
of depression , it is recommended to take the drug at a dose of 20-40 mg per
day. Typically, during the first week of treatment, the drug causes nausea,
provided that , however, tends to disappear in a short time. Continue therapy
for at least 3 weeks , unless otherwise directed by their doctor

Citalopram (eg Seropram ) : a dose of 20-40 mg per day. The dose Puu be
increased after a few weeks of therapy. Do not exceed 60 mg per day for adults
and 40 mg daily for the elderly.

Sertraline ( eg, Zoloft, sertraline , Tralisen ) : it is recommended to
start treatment with a dose of active equal to 50 mg / day. If necessary,
increase the dose of 50 mg every 2-3 weeks. Do not exceed 200 mg per day. The
maintenance dose is 50 mg per day .

Reuptake inhibitors of norepinephrine and dopamine

Bupropion
(eg Elontril , Wellbutrin , Zyban ) is a drug used in therapy to treat mild and
moderate forms of depression , the active ingredient , unlike the older drugs ,
drowsiness and does not interfere less on sexual desire . It is recommended to
start treatment with 100 mg of active , to be taken by mouth twice a day.
Maintenance dose : Take 75-100 mg of the drug per day , increasing the dose ,
if necessary, every 3 days (100 mg orally , three times a day ) . Do not exceed
450 mg per day , divided into 4 doses . Therapy should be continued until
remission of symptoms or as determined by your doctor. The drug is widely used
in therapy for smoking cessation .

Reuptake inhibitors of serotonin and norepinephrine

Duloxetine (eg Xeristar , Yentreve , Ariclaim , Cymbalta ) : indicated for the
treatment of major depression (in which the patient complains of severe
depressed mood for at least two consecutive weeks ) . It is recommended that a
dose of 40 mg , divided in two doses of 20 mg in 24 hours. In some cases, you
can take two doses of 30 mg each , without food.

Venlafaxine ( Efexor eg ) : indicats to treat
depression and generalized anxiety. Compared to the tricyclic antidepressants ,
venlafaxine does not produce the typical side effects antimuscarinic and
sedative effects . At the beginning of the treatment, it is recommended to take
75 mg of active per day, preferably divided into two doses , continue for 3-4
weeks. If necessary, in the first period , you can increase the dose up to 150
mg ( divided into two doses). In case of severe depression, increase the dosage
of 75 mg every 2-3 days . Do not exceed 375 mg per day.

Monoamine oxidase inhibitors ( MAOIs): these drugs represent a last resort , ie
when the treatment of depression with tricyclics or SSRIs did not bring any
benefit really evident in the depressed patient . These are second choice drugs
for the side effects they generate. MAOIs are often available as a combination
of drugs , in order to improve the final effect and restrict the timing of
treatment, therefore the probability of the occurrence of the side effects
decrease.

Phenelzine (eg. Margyl ) : initiating therapy with 15 mg of the drug , three
times a day . Maintenance dose : If necessary, increase the dose to 60-90 mg
per day. After you get the maximum benefit from your medication, it is
recommended to gradually decrease the dose (15 mg a day and every other day )
until it terminates administration.

Isocarboxazide (eg. Marplan) : start therapy for depression taking 10 mg
of active , twice a day . You can increase the dose of 10 mg every 2-4 days ,
up to 40 mg per day during the first week of therapy. Subsequently ,
increasing, if necessary, to 20 mg every week (not to exceed 60 mg / day).
Always divide the dose into 2-4 doses . Even in this case , after having
obtained the highest response terapica , gradually decrease the drug
administration , to avoid the rebound effect . The maintenance dose is 40 mg a
day, divided into several doses . Check with your doctor .

Tranylcypromine ( Parnate eg. ) : compared to phenelzine and
all'isocarboxazide , this drug is the most dangerous in terms of side effects ,
in addition to being the most exciting . In fact, the recommended dose for the
treatment of depression (10 mg , 2 times a day in the first week , 30 mg per
day in the second week , 10 mg daily maintenance dose ) should not be
administered after 15.00 ( gives insomnia due to hyper- excitability ) . This
medication is contraindicated for the treatment of depression of the child.

TherapyofDepression

Depression is anabrupt onset of
symptomsvaried, which mostlytakes the form ofapsychomotor retardationassociated withthe absence offeelings, loss of
sense ofhope andpossibilityin the future,lack ofenergy andfatigue,symptomsassociatedwiththe reduction /loss
ofsleep (typical is the early
morning awakening, around 4-5am),
appetite,sexual desire,and, in general, thedesire
todo thingsthat previouslygave you pleasure. Sometimes, however,
instead ofpsychomotor slowing,
there is a prevailing stateofagitation, anxiety, often associated with somatic
symptoms, such as pain,excessivecomplaints haveonyour physical condition, until concerns abouttheirphysical health, so similar to whathappenshypochondria.